Sigh. It had to happen at some point, right? I think it happens to all of us at some point. In the grand scheme of things, my pouch change fail really wasn't that bad. If this is the worst thing that happens to me in my life with an ileostomy, I am going to be ok.
I decided to combine my pouch change with a shower. This is a common method and I now know why. I got in the shower, went ahead and washed my hair, then used the adhesive remover wipes and took my old pouch off. Between the warm water and the wipes, it was tons easier to get the adhesive loose from my skin. I still have some of those pimply looking red marks, but the old ones were healed and these were new ones. I guess I'm not gaining ground on them, but at least I'm staying even. It was really nice to shower without the bag hanging off of my stomach! It was also nice to let the warm water run over and clean my stoma area really well. It felt great.
Out of the shower, I had to make sure my skin got nice and dry. Then I had to finish getting things ready to put the new pouch on. I still have to measure my stoma because it's changing size. They start out swollen immediately after surgery and then gradually shrink down for 4-6 weeks. I originally had an 1 1/2" stoma, now it's just between 1 1/4 and 1 1/8". I've been drawing the 1 1/4" line and then cutting just inside of it and that seems to work well. Measuring and cutting done, new pouch snapped onto the flange, barrier ring paste in place, new steri-strips applied, and then I went to put the new pouch on. I was instantly confused. Apparently the last one Molly put on me, and the one I did myself last time, was from the sample kit Hollister sent me. The ones I actually have on hand are different in that they don't have the same kind/amount of tape around the outside edges of the wafer. Once I figured that out I got everything pretty well smoothed down how it should be, but I was worried it wasn't going to hold as well as the other kind I was used to. I decided to wear my support belt though I hadn't been wearing it lately.
Fast forward several hours, and things were looking weird in the pouch. Keep in mind, I'm still using a clear front bag, so I can see everything inside there. (Sometimes gross, sometimes educational....it's a weird thing.) At any rate, it looked like there was "stuff" all built up around the stoma. This happens sometimes, no big deal, except when I went to push it down and away so it would fall down into the bag, I realized it was actually the barrier paste ring. Argh! Part of it had come through the flange and now I had pulled it away, allowing the output to now leak behind it and onto my skin. I realized this meant I was going to have to do a pouch change and take off the one I had just applied this morning. Lovely.
I set everything up and set about taking off the now defunct pouch. With the adhesive remover wipes, it actually wasn't bad. While I was removing it, I tried to think about what I did to make the barrier ring end up inside the flange like that. I remembered that I had pressed part of the inner edge down around the hole in the flange. Apparently this is a bad idea! I'm glad I figured out what went wrong though, so hopefully this won't happen again. Putting the new pouch on went smoothly and I feel better about the new style of wafer now that I've done it a second time. I did use a little Hytape on one side because the wafer edge wasn't wanting to stick to the steri-strips. I think they had adhesive remover residue on them. At any rate, I feel good about this application and it should hold up fine until Thursday or Friday when I'm ready to change it again.
I am a little curious as to what is going on with my stoma. It started out with the opening pointing straight ahead. Now it seems that the top has rotated toward my body and the opening now points more upward. It seems fairly close to my skin. I really hope it's not retracting or something because that can cause some problems. So far, everything is still going into the bag like it should so I'm just going to keep an eye on it. It's always something, right? Like I said, if these are the worst things to happen to me with all of this, then I'm going to be just fine. I just thought I'd share this incident so if you are new to ileostomy and struggling with your pouch changes you'll know it's not just you!